Infliximab Antibodies, Anti-Drug Antibodies, ADA

Immunology

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Description

Infliximab is a chimeric monoclonal antibody directed towards TNF alpha [1,2,3]. It is used in the treatment of chronic inflammatory conditions such as inflammatory bowel disease and rheumatic disease [4]. Ongoing use of infliximab may initiate an immune response in a subgroup of patients leading to the production of anti-infliximab antibodies. These antibodies neutralise the effect of infliximab. Patients with positive anti-infliximab antibodies are more likely to have infusion related reactions and loss of response to the therapy over time. [1,2,3,4]. The measurement of infliximab drug levels and infliximab antibody levels can aid in clinical decision making by identifying if a trough therapeutic drug level has been reached and determining if anti-drug antibodies are present if the trough level is low. Dose may be increased if there are no anti-drug antibodies present, or stopped if the patient has developed antibodies [3].

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Indications

Investigation of low trough infliximab level or in patients experiencing adverse reactions following infliximab infusion.

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Sample Type

Serum (Gel 5ml Yellow) or Plasma (2mL EDTA). Requests from outside Sheffield: Transport at ambient temperature via Royal Mail or Courier.

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Reference Range

Negative = <10 AU/mL.

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Turnaround Time

Within 10 days

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Testing Frequency

As required

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References

Lee LY, Sanderson JD and Irving PM. Anti-infliximab antibodies in inflammatory bowel disease: prevalence, infusion reactions, immunosuppression and response, a meta-analysis. Eur J Gastroenterol Hepatol. 2012. 24(9):1078-1085. [Ref 1].Steenholdt C, Bendtzen K, Brynskov J, et al. Measurement of infliximab and anti-infliximab antibody levels can help distinguish maintenance versus loss of response. Gastroenterol Hepatol. 2012. 8(2): 131-134. [Ref 2].Hendy P. Infliximab and anti-infliximab antibody levels in Crohns disease. Frontline Gastroenterol. 2014. 0: 1-2. [Ref 3].Krintel SB, Grunert VP, Hetland ML, et al. The frequency of anti-infliximab antibodies in patients with rheumatoid arthritis treated in routine care and the associations with adverse drug reacitons and treatment failures. Rheumatology. 2013. 52(7): 1245-1253. [Ref 4].

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See Also

Infliximab drug level.

Please note: the above information is subject to change and we endeavour to keep this website up to date wherever necessary.